Claim total
$284.85
base $93.39 · payer covered $249.85
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2022-08-21
- Stop
- 2022-08-21
The parties
- Provider
- provider Heriberto Smitham
- Payer
- payer Dual Eligible
Record id
014b9cfb-a71a-d032-81cc-7aa8498d621e